If you have gone through the potentially scary and painful experience of a deep vein thrombosis (blood clot) within the past two years you could be in the 50% group of patients that will also go on to develop PTS, which is the medical acronym for post thrombotic syndrome. 

You may not even have been informed about the potential occurrence of this rather serious long-term complication after developing a blood clot.  This could simply have been an oversight or your healthcare provider may be unaware of this problem.

What is Post Thrombotic Syndrome (PTS)?

Less often it is also referred to as post-phlebitic syndrome or venous stress disorder.

Post thrombotic syndrome is a term to describe the effects you may experience some time after you have had a blood clot, for example in the deeper veins of your legs.  The cause is usually traceable to vein damage (e.g. damaged valves, increased pressure in the veins, improper blood flow or pooling of the blood in the legs).  It is possible to develop post thrombotic syndrome first, if a thrombosis (blood clot) goes undetected.

Signs and Symptoms of PTS

Nevertheless, the incidence of PTS after developing a blood clot (DVT) is very real and often difficult to diagnose.  Some people experience signs of post thrombotic syndrome merely as itching or cramping type symptoms.  Other more clearly defined signs of PTS manifest themselves as

  • Pain in the affected limb
  • Swelling of the leg or arm
  • Accumulating fluid in a limb
  • Feeling of heaviness in the affected area
  • Skin color change
  • Irritation, swelling and tenderness in the affected area
  • Open sores
  • Venous ulcers

All of these symptoms can differ from patient to patient and they can change over time, which makes diagnosing PTS a rather challenging task.  These symptoms are also not specific to post thrombotic syndrome.  Therefore if you experience any of above described symptoms your physician will need to perform specific testing to determine if you in fact have PTS or if you are having a new or undiagnosed thrombosis.  The relevant tests are compression ultrasound, continuous wave Doppler ultrasound and color duplex scanning.

Increased Risk for Post Thrombotic Syndrome (PTS)

It should be said that women are considerably more likely to develop post thrombotic syndrome than men.  Individuals who have experienced deep vein thrombosis are prime candidates for developing PTS.  In addition, certain reasons and conditions create an increased risk for some DVT patients:

  • Increased age
  • Being overweight
  • History of DVT in the upper leg
  • Severe DVT
  • Pregnancy
  • Recent surgery
  • Tobacco use
  • Use of birth control pills
  • Kidney disorders
  • Varicose veins

Prevention and Treatment Options of Post Thrombotic Syndrome

The best way to avoid post thrombotic syndrome is to prevent blood clots from forming to begin with.  Treatment options of PTS should incorporate some or all of the following as recommended and guided by your physician:

  1. Activating your leg muscle pumps with regular leg exercises (such as walking, hiking, biking, swimming)
  2. Wearing graduated compression stockings regularly to stimulate and optimize blood circulation in your legs
  3. Taking blood thinner medication

Daily use of compression stockings with graduated compression can significantly reduce the risk of post thrombotic syndrome (PTS) in patients that have had a deep vein thrombosis (DVT).  Graduated compression support hose may also prevent any worsening of existing PTS.

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Gregory

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